No

Proton Pump Inhibitor

Short-term treatment (up to 4 weeks) for healing and symptom relief of active duodenal ulcers (should not be used for maintenance therapy of duodenal ulcers); as part of a multiple drug regimen for H. pylori eradication; short-term treatment of symptomatic GERD; up to 8 weeks of treatment for all grades of erosive esophagitis (8 additional weeks can be given for incompletely healed esophageal erosions or for recurrence); and long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome

B

Should not be taken by anyone with a known hypersensitivity to lansoprazole or any of the formulation's components

Liver disease may require dosage reductions

1% to 10%:

Central nervous system: Fatigue, dizziness, headache

Gastrointestinal: Abdominal pain, diarrhea, nausea, increased appetite, hypergastrinoma

<1%: Rash, tinnitus, proteinuria

Symptoms of overdose include hypothermia, sedation, convulsions, decreased respiratory rate demonstrated in animals only

Treatment is supportive; not dialyzable

CYP2C19 enzyme substrate, CYP3A3/4 enzyme substrate (minor)

Lansoprazole is unstable in acidic media (eg, stomach contents) and is, therefore, administered as enteric coated granules in capsule form; the capsule contents (granules) may be given via nasogastric tube when mixed (not crushed) with apple juice

Similar to omeprazole; a proton pump inhibitor which decreases acid secretion in gastric parietal cells

Duration: 1 day

Absorption: Food affected

Bioavailability: 80% (50% if given 30 minutes after food)

Peak plasma levels: 1.7 hours

Protein binding: 97%

Metabolism: Hepatic and in parietal cells

Half-life: 2 hours (2.9 hours in elderly, 7 hours with hepatic impairment)

Excretion: 33% in urine; 67% in feces

Duodenal ulcer: 15 mg once daily for 4 weeks; maintenance therapy: 15 mg once daily

Gastric ulcer: 30 mg once daily for up to 8 weeks

GERD: 15 mg once daily for up to 8 weeks

Erosive esophagitis: 30 mg once daily for up to 8 weeks, continued treatment for an additional 8 weeks may be considered for recurrence or for patients that do not heal after the first 8 weeks of therapy. Maintenance therapy: 15 mg once daily.

Hypersecretory conditions: Initial: 60 mg once daily; adjust dose based upon patient response and to reduce acid secretion to <10 mEq/hour (5 mEq/hour in patients with prior gastric surgery); doses of 90 mg twice daily have been used; administer doses >120 mg/day in divided doses.

Helicobacter pylori-associated antral gastritis: 30 mg/day for 2 weeks (in combination with 1 g amoxicillin and 500 mg clarithromycin given twice daily for 14 days). Alternatively, in patients allergic to or intolerant of clarithromycin or in whom resistance to clarithromycin is known or suspected, lansoprazole 30 mg every 8 hours and amoxicillin 1 g every 8 hours may be given for 2 weeks

Dosing adjustment in hepatic impairment: Dose reduction is necessary for severe hepatic impairment

Administer before eating

Patients with Zollinger-Ellison syndrome should be monitored for gastric acid output, which should be maintained at 10 mEq/hour or less during the last hour before the next lansoprazole dose; lab monitoring should include CBC, liver function, renal function, and serum gastrin levels

May cause drowsiness or dizziness

None reported

No information available to require special precautions

No effects or complications reported

Take as directed, before eating. Do not crush or chew granules. Patients who may have difficulty swallowing capsules may open the delayed-release capsules and sprinkle the contents on applesauce, pudding, cottage cheese, yogurt, or Ensure. Report unresolved fatigue, diarrhea, or constipation, and appetite changes. Breast-feeding precautions: Do not breast-feed.

Capsule, delayed release: 15 mg, 30 mg

Chun AH, Eason CJ, Shi HH, et al, "Lansoprazole: An Alternative Method of Administration of a Capsule Dosage Formulation," Clin Ther, 1995, 17(3):441-7.